When Nick Toumpas steps down from his role as commissioner of the Department of Health and Human Services at the end of this week, he’ll leave behind a job leading the largest state agency – and arguably its most complex – at a time when New Hampshire’s population is aging, its health needs are becoming increasingly complicated and budgets are stretched thin.
Toumpas started with DHHS in the 1970s – back when it was still just the “Division of Welfare,” as he recalled this week – and took a detour to work in the private sector for several decades before returning to the agency in the early 2000s. He officially took over as commissioner in 2007.
In a wide-ranging interview with Laura Knoy on Tuesday’s edition of The Exchange, Toumpas reflected on some of the biggest challenges facing the agency during his eight-year tenure and outlined his hopes for the future of health policy in the Granite State once he leaves.
The full interview is available here, but here are some of the major takeaways.
- DHHS is large and – some might say, stretched precariously thin – but Toumpas said there’s value in being able to provide a “holistic” approach.
- On the demands of being DHHS commissioner during a time of increased polarization, Toumpas said: “I know I’m in a political role, but I try not to play politics.”
- DHHS answers to many different groups with many compelling needs, and balancing those calls for action can sometimes be tricky – but Toumpas said it’s necessary to take a big-picture view.
- Medicaid expansion has been a significant step forward for the state, in Toumpas’s view, and he hopes the Legislature opts to reauthorize the program when it’s up for debate this year.
- Workforce issues – in the community supports system and within DHHS itself – have posed significant challenges. Such issues played a role in the problems seen around the developmental disabilities waitlist, for example.
- While Toumpas acknowledged that the issues at Lakeview Neurorehabilitation Center (documented by NHPR’s Jack Rodolico) prompted DHHS to reevaluate some of its processes, the commissioner said he doesn’t believe these are indicative of more systemic issues within DHHS regulatory oversight.
- Asked for advice to those considering public service, in DHHS or elsewhere, Toumpas said agencies will need to adapt to recruit and maintain younger workers -- but he said it’s important for anyone going into public service to have an “inherent desire to help people.”